Section 350.1230  Nursing Services

a)         Each facility shall have a full-time director of nursing services (DON) who is a registered nurse (RN) and whose only responsibility is the immediate supervision of the facility's health services.  This person shall be on duty a minimum of 36 hours, four days per week.  At least 50 percent of this person's hours shall be regularly scheduled between 7 A.M. and 7 P.M.

1)         A registered nurse or licensed practical nurse shall be on duty 24 hours per day and seven days per week in charge of health services at all times when the director of nursing services is not on duty.  The nurse shall be a registered nurse when required by the medical and/or nursing needs of the residents.

2)         A facility may, with written approval from the Department, have two registered nurses share the duties of this position if the facility is unable to obtain a full-time person.  Such an arrangement will be granted approval only through written documentation that the facility was unable to obtain the full-time services of a qualified individual to fill this position. Such documentation shall include, but not be limited to:  an advertisement that has appeared in a newspaper of general circulation in the area for at least three weeks; the names, addresses and phone numbers of all persons who applied for the position and the reasons why they were not acceptable or would not work full time; and information about the number and availability of registered nurses in the area.  The Department will grant approval only when such documentation indicates that there were no qualified applicants who were willing to accept the job on a full-time basis, and the pool of registered nurses available in the area cannot be expected to produce, in the near future, a qualified person who is willing to work full time.

3)         In facilities with a capacity of fewer than 50 beds, this person (or these persons) may also provide direct patient care, and this person's time may be included in meeting the staff to resident ratio requirements.

b)         Residents shall be provided with nursing services, in accordance with their needs, which shall include, but are not limited to, the following: The DON shall participate in:

1)         Pre-admission evaluation study and plan.

2)         Evaluation study, program design, and placement of the resident at the time of admission to the facility.

3)         Periodic reevaluation of the type, extent, and quality of services and programming.

4)         Development of discharge plans, and the referral to appropriate community resources.

5)         Training in habits in personal hygiene and activities of daily living.

6)         Development of a written plan for each resident to provide for nursing services as part of the total habilitation program.

7)         Modification of the resident care plan, in terms of the resident's daily needs, as needed.

c)         A registered nurse shall participate, as appropriate, in planning and implementing the training of facility personnel.

d)         Direct care personnel shall be trained in, but are not limited to, the following:

1)         Detecting signs of illness, dysfunction or maladaptive behavior that warrant medical, nursing or psychosocial intervention.

2)         Basic skills required to meet the health needs and problems of the residents.

3)         First aid in the presence of accident or illness.

e)         Sufficient, appropriately qualified nursing staff shall be available, which may include licensed practical nurses and other supporting personnel, to carry out the various nursing service activities.

f)         The individual responsible for providing nursing services shall have knowledge and experience in the field of developmental disabilities.

g)         Nursing service personnel at all levels of competence and experience shall be assigned responsibilities in accordance with their qualifications.

(Source:  Amended at 28 Ill. Reg. 7653, effective May 24, 2004)